Hospital death in Ireland renews fight over abortion

Dublin: The death of a woman who was reportedly denied a potentially lifesaving abortion even while she was having a miscarriage has revived debate over Ireland's almost total ban on abortions.

The woman, Savita Halappanavar, 31, a dentist who lived near Galway, was 17 weeks pregnant when she sought treatment at University Hospital Galway on Oct. 21, complaining of severe back pain.

Halappanavar was informed by senior hospital physicians that she was having a miscarriage and that her fetus had no chance of survival. However, despite repeated pleas for an abortion, she was told that it would be illegal while the fetus' heart was still beating, her husband, Praveen Halappanavar, said. (Read: Savita's death a matter of concern, says Indian government)

It was not until Oct. 24 that the heartbeat ceased and the remains of the fetus were surgically removed. But Savita Halappanavar contracted a bacterial blood disease, septicemia. She was admitted to intensive care but never recovered, dying on Oct. 28.

Praveen Halappanavar, in an interview with The Irish Times from his home in India, said his wife was told after one request, "This is a Catholic country."

Two investigations into the case have been announced, and politicians have been quick to express their condolences and to call for legal clarity. Kathleen Lynch, a junior health minister, said medical professionals needed guidelines to deal with such circumstances.

In a statement, the hospital said it would cooperate fully with any inquest but that it had not started its own review because it wanted to consult the woman's family first.

Praveen Halappanavar told the newspaper that he still could not believe his wife was dead.

"I was with her those four days in intensive care," he said. They kept telling me: She's young. She'll get over it.' But things never changed; they only got worse. She was so full of life. She loved kids.

"It was all in their hands, and they just let her go. How can you let a young woman go to save a baby who will die anyway?"

But Halappanavar said he saw no use in being angry. "I've lost her," he said. "I am talking about this because it shouldn't happen to anyone else."

Medical professionals were less forgiving. During a miscarriage, the cervix is opened, exposing the woman to infection, and the longer the miscarriage persists, the greater the risk, said a prominent medical commentator here, Dr. Muiris Houston.

While Savita Halappanavar's death was "on the rare end of the spectrum," and the facts surrounding the case are not all known, Houston said, she "undoubtedly needed to go to theater," meaning to surgery.

"If she had gone to theater earlier she might still have died, but perhaps not," he said. "Medicine is now increasingly driven by guidelines, and the question must be, 'Did the hospital have protocols in place when a woman presented with such a condition?"'

The legal issues are, if anything, more clouded. In 1992, the Irish Supreme Court ruled that abortion was permissible in cases where there was a "real and substantial risk" to the life of a pregnant woman - including the possibility of suicide.

But 20 years later, the Irish government has still not passed a law to this effect.In 2010, the European Court of Human Rights found that Ireland was in violation of the European Convention on Human Rights by failing to provide an accessible and effective procedure to ascertain whether a woman qualified for a legal abortion.

In response, the current coalition government commissioned a report from an expert group on the issue. It was initially expected in July, but was then postponed until September - a deadline also missed. Given the divisiveness of the abortion issue in Ireland, which has prompted two bitterly fought referendums, successive governments have avoided passing any legislation.

The report was eventually delivered Tuesday night, hours before news broke of Savita Halappanavar's death. The government warned people not to link the two, but inevitably the death has led to calls for urgent reform.